Private Lesson Application Form - Credit Card Payment
Thank you for taking private lessons at Plugged In and for completing this short application form.
Questions marked with a red asterisk are required and must be answered before submitting your application.
Plugged In is excited to have you participate in our private lesson program!
Parent Contact Information
Emergency Contact Information
If the student's parents are unreachable during an emergency whom should we contact?
Ex: student excels in structured environment, student requires breaks, student is shy, etc.
To participate in Plugged In you must read, understand, and agree to the following policies. If you have questions regarding any of the following policies please contact Plugged In directly.